Monday, July 10, 2017

Let's open North Carolina's State Health Plan to non-State employees


United States Senator Rand Paul, R-Kentucky, in a 24-hour "cable" news station discussion about the Senate health care bill which he does not support (as of this writing), made an interesting suggestion: Let those who need Obamacare join plans with established entities that have group policies instead of the exchanges.

It's an interesting proposition but his proposal went nowhere with the interviewers because it seems most reporters care more about the politics of Washington than the actual exchange and discussion of ideas. Time was fleeting for the television network and a commercial break was more important. So the questioner pressed for an answer to 1. If the Senate bill will pass; and, 2. What would happen to the thousands in Kentucky who could be cut from the rolls of Obamacare if the bill did pass? The media doesn't care for a solid discussion of ideas for saving healthcare; they only care about asking glamour questions and about getting in the last word.

While I may not agree with much of what Paul wants to do with Obamacare and other federally funded health care solutions, Paul may be on to something constructive for health care insurance. The real problem is less about the cost of insurance and more about the cost of healthcare: the charges made by non-for-profit hospitals who hoard cash instead of reducing costs, the prices physicians charge that are different from office door to office door, the cost of prescriptions, though maybe in some cases such as opiods higher prices could lead to a lower death rate for the use thereof, and so on and so forth. Healthcare insurance rates as based on the costs of healthcare and what is and is predicted to be paid for that care.

So, what could be constructive about what Senator Paul said in that brief moment? Well, as related to North Carolina where I live, I ask: What if legal North Carolinians who are not in private group policies and who are on or should be on Obamacare (Affordable Care Act) are allowed to take part in the North Carolina State Health Plan designed for state and county employed teachers and state employees?

I'm not suggesting or conjecturing this non-state employed group pay the same premium prices for the same policy or coverage as a State employee because State employees policies are supplemented as a perk of employment. But I am suggesting these non-employees be allowed to buy into the system as what is known as 100% contributory subscribers, paying full price premiums and being covered the same as State employees.

A cursory look at two plans -- the 70/30 State Health Plan for individual, individual and spouse, individual and children, and families and the Obamacare rates for the Blue Cross Blue Shield traditional 70/30 plan -- reveals they are nearly identical in premium rates. However, the benefits to the State Health Plan are much better than the ACA benefits including lower deductibles, lower co-pays, and other financial pluses. In other words, for the policy holder, the State Health Plan is more affordable, a lot more affordable than Obamacare with less worries when someone needs care and insurance to cover that care.

However, when reality hits, affordability is relative to the subscriber. With Obamacare, there are financial supplements available. So, even for being able to subscribe to the State Health Plan, for those requiring subsidies, let's find a way to help by using tax benefits, government financial support, and Medicaid money based on income or some other reasonable formula, if necessary. The effort would be to put everyone in North Carolina who needs it on the State Health Plan. The same for others in other states and U.S. territories.

Currently, there are more than 710,000 North Carolina teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents on the State Health Plan. There are about 550,000 North Carolinians insured through the ACA. Why not add those 550,000 on Obamacare to the State Health Plan? Makes sense to me.

The first response to that last question would be the cost to support the additional subscribers of the State Health Plan, but that's probably a pittance compared to the overall savings, especially when the State Treasurer hopefully negotiates better rates with BCBS and United Healthcare (for retirees) when such large numbers are added, especially if many of them are healthy. It's the healthy ones who make Obamacare work. They pay the freight so those who need health care can get it at reasonable rates. The healthy need to understand that one day they'll need it as well. It's the healthy ones who make all insurances work as it reduces the risk of lots of high payouts while at the same time premiums roll in from subscribers who need little medical attention.

I think Senator Rand Paul said something very useful and constructive that could be applied to all states, not just North Carolina. However, it appears no one has picked up on his thoughts. I did, and I hope what I'm suggesting here has merit. I realize what's inside the policy -- what's covered -- is more important to many than the coverage itself. Leave in pre-existing conditions, leave in birth-control coverage and support for Planned Parenthood, leave in everything that's in today's Obamacare. Or allow for opting out of coverage that doesn't diminish the entire plan. Those are the weeds of the possibilities and very important, but a big picture is better than no picture as all.

There's must be something -- probably a lot of -- good that would come by moving 22 million from Obamacare to the State Health Plan in every state in the United States.
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